Provider Demographics
NPI:1205581931
Name:NARCISSE, ADELINE RICHMOND (APRN)
Entity type:Individual
Prefix:
First Name:ADELINE
Middle Name:RICHMOND
Last Name:NARCISSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 NW PEACOCK BLVD STE 202
Mailing Address - Street 2:
Mailing Address - City:PORT SAINT LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34986-2222
Mailing Address - Country:US
Mailing Address - Phone:772-878-6599
Mailing Address - Fax:
Practice Address - Street 1:293 NW PEACOCK BLVD STE 202
Practice Address - Street 2:
Practice Address - City:PORT SAINT LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34986-2222
Practice Address - Country:US
Practice Address - Phone:772-878-6599
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11013491363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner